骨科英文书籍精读（141）｜掌骨骨折
METACARPAL FRACTURES
The metacarpal bones are vulnerable to blows and falls upon the hand, or the longitudinal force of the boxer’s punch. Injuries are common and the bones may fracture at their base, in the shaft or through the neck.
Angular deformity is usually not very marked, and even if it persists, it does not interfere much with function. Rotational deformity, however, is serious. Close your hand with the distal phalanges extended, and look: the fingers converge across the palm to a point above the thenar eminence; malrotation of the metacarpal (or proximal phalanx) will cause that finger to diverge and overlap one of its neighbours.
Thus, with a fractured metacarpal it is important to regain normal rotational alignment.
The fourth and fifth metacarpals are more mobile at their base than the second and third, and therefore are better able to compensate for residual angular deformity.
Fractures of the thumb metacarpal usually occur near the base and pose special problems. They are dealt with separately below.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
converge /kənˈvɜːrdʒ/vt. 使汇聚vi. 聚集；靠拢；收敛
thenar /'θi:nɑ:, -nə/n. 手掌adj. 鱼际的；拇指球的；手掌的
eminence /ˈemɪnəns/n. 显赫；卓越；高处
thenar eminence鱼际隆起
diverge /daɪˈvɜːrdʒ/vt. 使偏离；使分叉vi. 分歧；偏离；分叉；离题
compensate /ˈkɑːmpenseɪt/vt. 补偿，赔偿；付报酬vi. 补偿，赔偿；抵消
pose special problems构成特殊问题
百度翻译：
掌骨骨折
掌骨容易受到击打而落在手上，或拳击手的纵向力。损伤是常见的，骨骼可能在其底部、骨干或颈部骨折。
角畸形通常不是很明显，即使持续存在，也不会对功能造成太大影响。然而，旋转畸形是严重的。双手合拢，远端指骨伸展，看：手指在手掌上会聚到大鱼际隆起上方的一点；掌骨（或近节指骨）旋转不良会导致鱼鳍分开并与相邻的指骨重叠。
因此，对于骨折的掌骨来说，恢复正常的旋转对准是很重要的。
第四和第五掌骨比第二掌骨和第三掌骨在其基底部的活动性更强，因此能够更好地补偿残余的角度偏移。
拇指掌骨骨折通常发生在底部附近，并造成特殊问题。下面分别处理。